In new guidance, the National Institute for Health and Clinical Excellence (Nice) has said that hospitals should also have a co-ordinated "hip fracture programme" to help patients recover faster.

Nice added that surgery should take place the same day or the day after hospital admission. Some patients currently wait several days.

Treating hip fractures costs UK medical and social care an estimated £2bn every year. Nice says implementing the changes in the guideline would cost little and would actually save money in the long term, while leading to a better quality of life for the patient.Around 70,000-75,000 hip fractures occur each year in the UK, and this number is expected to rise to 100,000 by 2020 because of the ageing population.

Professor Cameron Swift, emeritus professor of healthcare of the elderly at King's College London and chairman of Nice's guideline development group, said: "We have got, with hip fracture, a healthcare challenge over the coming decades of potentially epidemic proportions.

"So often when we talk about our growing numbers of older people we encounter a sense of gloom and despair almost that we've got an insoluble problem. We've found there are solutions which can be not only effective but cost-effective in addressing this particular challenge."

The hip fracture programme involves the hospital reaching out to links in the community. A physician specialising in the needs of older people, and with a particular interest in hip fracture, works alongside colleagues in orthopaedic surgery and anaesthetics.

Professor Swift said: "From the moment the patient comes into hospital, the care is integrated and planned throughout the patient's stay. It delivers the needs of patients in a way that is cost-effective to hospital trusts, almost contrary to expectation. We can reduce hospital stay in a way which is not throwing older people out early but achieving an outcome which gives them independence and quality of life."

Tim Chesser, consultant orthopaedic and trauma surgeon with North Bristol trust's Frenchay and Southmead hospitals and a member of the guideline development group, said: "Hip fracture patients present as emergencies but are often given low priority in the emergency setting, and have to wait several days before they are allowed to start recovering from the fracture."

Junior teams are often involved in their care, he added. "We know that early surgery minimises complications and reduces mortality. We are introducing some of these guidelines in our own hospital and have seen a drop in mortality, complications and length of stay. We have tried to introduce this integrated care over the last two to three years. Our length of stay has gone down six days and mortality 2% in that time."

Asked why hip fracture patients sometimes had low priority in the system, he said it is because they are old and do not have a voice. "It's our job to give them a voice," he said. "We reckon that probably less than 50% are being operated on in less than 36 hours. But four years ago it was less than 50% in 48 hours, 72 hours, so we're getting better as we go along." He said hip fractures could be prioritised by reorganising services.

The proposals should be "cost neutral" for hospital trusts, Professor Swift added. "We can make acute hospitals older-person friendly."

Nice said it had estimated the annual cost of fully implementing the guideline to be £1.4m across all provider organisations in England, once potential savings had been taken into account. Potential savings considered include reduced stay in hospital, a reduction in the number of follow-up procedures, and earlier return to mobility for patients.

A Department of Health spokeswoman said: "With an ageing population who often have complex health needs, getting services right for people with hip fractures is vital. We welcome this Nice clinical guideline which reinforces the existing best practice. But there is still an unacceptable amount of variation in quality of falls services.

"That is why the government is promoting prevention and investing in services to help people with their rehabilitation. Next month the Department of Health is holding a Falls and Fractures Summit with Age UK and the National Osteoporosis Society to address variation in the quality and availability of falls and fracture services locally."

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